The decision whether or not to outsource your billing is less complex of a decision than most physicians make it out to be. Today’s medical billing takes a highly specialized set of skills and resources to be successful. Billing has become an ever-changing complex field of codes, modifiers, rules and regulations. So here are the top 5 reasons you should outsource your practice’s medical billing function:
1. Professional billing companies offer economies of scale, dividing infrastructure costs among many clients. There are two very basic components to running a practice: treating patients and getting paid for those services. Outsourced billing has become popular because it’s cheaper and more efficient. With ever-increasing fee reductions, fewer patient visits, and constantly changing regulations, it has become necessary to operate every practice efficiently in order to survive in today’s economy.
2. In the next few years, private practices will face unprecedented reimbursement challenges, not the least of which is the imposition of Medicare fee reductions. Congress will continue to lower provider fees in an attempt to reduce Medicare’s deficit.
3. ICD-10 (10/1/2013) - This is the biggest change in medical billing in years. The move to ICD-10 features fundamental changes that the average practice biller is not set up to handle The shear change in the volume of codes is daunting. ICD-9 has 13,000 diagnosis codes and 4,000 procedure codes totaling 17,000 codes, while ICD -10 has 68,105 diagnosis codes and 72,589 procedure codes totaling 140,694 codes. If they’re good, the billing company you interview will have the infrastructure and education to handle this transition with little or no interruption in your cash flow. This function has evolved to the point where you really need a certified coder to do your billing. And those certification exams are not easy to pass.
4. Billing companies also have programs designed to accelerate cash flow. Patient eligibility verifications let you see a patient’s eligibility on the date of service and collect the correct copay at the time of the visit. Good billing companies use those economies of scale to offer programs for online patient bill pay so you get your funds deposited into your account on the next business day. According to the industry average, this reduces overall accounts receivable by 35%. Sending statements via email ensures immediate delivery without the cost of supplies and postage, further cutting down on overhead; and you can also email patients to remind them of physicals, rechecks, immunizations, etc.
Claim scrubbers audit first time claims submissions, reducing the need for re-bills and edits. This means you get your reimbursement faster, on the first pass, without all the back and forth, and features like these can be had for really low rates with the collective negotiating power that comes from using a billing service.
5. Money can be lost from preventable issues. All billers need constant CEU’s to remain current. In a billing review we performed recently for a large surgical practice, we found a loss of $600,000 in one year, mainly due to the use of an outdated fee schedule. The truth is providers rely on billers for their income. The range of certifications available to those in the billing industry is as much an alphabet soup as those available to physicians themselves. So why would anyone want an uneducated biller or coder?
These are only five of the reasons you should look for an educated, certified coder to do your office’s billing. There are many more that we won’t go into here, but the bottom line is that billing is a function you should not trust to the unprepared.
Barry Shatzman is a Certified Healthcare Billing & Management Executive and Chief Operating Officer of Medical Billing Resources, Inc., in Farmington Hills, Michigan. Please feel free to comment on this post or to contact him directly at barry@medicalbillingresources-mi.com, or at 248-932-2607.
If you're concerned about the quality of billing being performed at your practice, you might want to take advantage of our free medical billing review, or reimbursement analysis. We audit for missing codes, correct fee schedules, appropriate modifiers, and regulatory compliance, among other things. This is a great way to see if your billing and coding function is up to par with current industry standards.
